title: United Kingdom 30-day mortality rates after surgery for pediatric central nervous system tumors.
abstract: OBJECTIVE
  In an increasing culture of medical accountability, 30-day operative mortality rates remain one of the most objective measurements reported for the surgical field. The authors report population-based 30-day postoperative mortality rates among children who had undergone CNS tumor surgery in the United Kingdom.
  
  
  METHODS
  To determine overall 30-day operative mortality rates, the authors analyzed the National Registry of Childhood Tumors for CNS tumors for the period 2004-2007. The operative mortality rate for each tumor category was derived. In addition, comparison was made with the 30-day operative mortality rates after CNS tumor surgery reported in the contemporary literature. Finally, by use of a funnel plot, institutional performance for 30-day operative mortality was compared for all units across the United Kingdom.
  
  
  RESULTS
  The overall 30-day operative mortality rate for children undergoing CNS tumor surgery in the United Kingdom during the study period was 2.7%. When only malignant CNS tumors were analyzed, the rate increased to 3.5%. One third of the deaths occurred after discharge from the hospital in which the surgery had been performed. The highest 30-day operative mortality rate (19%) was for patients with choroid plexus carcinomas. A total of 20 institutions performed CNS tumor surgery during the study period. Rates for all institutions fell within 2 SDs. No trend associating operative mortality rates and institutional volume was found. In comparison, review of the contemporary literature suggests that the postoperative mortality rate should be approximately 1%.
  
  
  CONCLUSIONS
  The authors believe this to be the first report of national 30-day surgical mortality rates specifically for children with CNS tumors. The study raises questions about the 30-day mortality rate among children undergoing surgery for CNS tumors. International consensus should be reached on a minimum data set for outcomes and should include 30-day operative mortality rates.
authors.affiliation: Department of Neurosurgery, Royal Hospital for Sick Children, Glasgow, Scotland, UK.
authors.forename: Roddy
authors.initials: R
authors.lastname: O'Kane
authors.forename: Ryan
authors.initials: R
authors.lastname: Mathew
authors.forename: Tom
authors.initials: T
authors.lastname: Kenny
authors.forename: Charles
authors.initials: C
authors.lastname: Stiller
authors.forename: Paul
authors.initials: P
authors.lastname: Chumas
mesh_terms: D000293:Adolescent; D016543:Central Nervous System Neoplasms / Q000401:mortality* / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012042:Registries; D015996:Survival Rate; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology